Complications of percutaneous endoscopic gastrostomy-jejunostomy for levodopa/carbidopa infusion in advanced Parkinson's disease

Ana Olivares,Josè Carlos Subtil,David Collado,Marta Calvo,Inmaculada Chico,Carlos Marra,Sarbelio Rodríguez,Luis Ramon Rábago,Miguel Muñoz-Navas,Rafael Sánchez-Estella,Eduardo Olivo

doi:10.4081/gi.2012.e4

Abstract

Continuous infusions of levodopa directly into the duodenum-yeyunum is an effective therapy to reduce daily off time in an advanced stage of Parkinson's disease, but it is not without complications, particularly device related problems. We present our experience in three Spanish hospitals with these complications, including a severe case with migration, several decubitus ulcers, and one case of perforation of the bowel and finally death.

Highlights

Ana Olivares,[1] David Collado,[1] complications of the infusion device cannot be ignored.[3,4,5,6,7] The aim of this paper is to discuss the four cases and give an estimated number of the severe complications in our country
-com Introduction n Parkinson’s disease at an advanced stage o determines motor fluctuations and dyskinesias N that oral levodopa administration can no placed through a percutaneous gastrostomy (Freka P.E.G CH) made two months earlier with no complications
Eight months after the system had been put in place, the patient was admitted with acute abdominal pain, vomiting and pump malfunction

Summary

Introduction

Ana Olivares,[1] David Collado,[1] complications of the infusion device cannot be ignored.[3,4,5,6,7] The aim of this paper is to discuss the four cases and give an estimated number of the severe complications in our country. A 65-year-old male patient with Parkinson’s disease at stage IV of Hoen Yhar (motor fluctuations and dyskinesias) was proposed for the Duodopa® continuous infusion treatment. Doce de Octubre, Madrid; 4Surgical Deparment, Hospital Severo Ochoa, ly Leganés, Madrid, Spain e on Abstract s Continuous infusions of levodopa directly u into the duodenum-yeyunum is an effective l therapy to reduce daily off time in an advanced ia stage of Parkinson’s disease, but it is not without complications, device related rc problems.

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Conclusion